402 Obstetrics and Gynecology Board Review •••
❍ List the criteria for the diagnosis of anorexia nervosa in an adolescent female.
(1) Refusal to maintain normal weight for age and height (<85% recommended level).
(2) Morbid fear of becoming fat.
(3) Disturbance of body image.
(4) Absence of menstruation for three consecutive cycles.
❍ List some of the laboratory findings found in anorexia nervosa.
(1) Prepubertal levels of FSH and LH.
(2) Diminished response toGnRH.
(3) Postmenopausal levels of estrogen.
(4) Absence or reversal of normal circadian rhythm of plasma cortisol.
(5) Reduction in metabolic clearance rate of cortisol.
(6) Incomplete suppression of adrenal corticotropin and cortisol by dexamethasone.
❍ List the criteria for the diagnoses of bulimia nervosa.
(1) Uncontrolled binge eating at least twice weekly for at least 3 months.
(2) Recurrent inappropriate compensatory behavior to prevent weight gain, such as, self-induced vomiting,
laxatives or diuretics, strict dieting or fasting, or vigorous exercise averaging at least twice weekly for 3 months.
(3) Over concern with weight and body shape.
❍ List three physical findings that may be present in a patient with bulimia nervosa.
(1) Erosion of dental enamel.
(2) Calluses on dorsal aspects of the hands.
(3) Parotid hypertrophy.